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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. BRIAN LESLIE WALLACE, PT, DPT, OCS

Active

MR. BRIAN LESLIE WALLACE, PT, DPT, OCS is a Physical Therapy Assistant healthcare provider located in FORT BRAGG, North Carolina. NPI 1790888501 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · FORT BRAGG, NC

Registration Details

NPI Number
1790888501
Provider Type
Individual
Gender
Male
NPI Issued
Sep 7, 2006 (19.89662719984 yrs)
Last Updated
Jun 18, 2025
Licenses
10128 (NC)
10128 (NC)

Practice Information

Address
2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER
FORT BRAGG, NC, 283106920
Browse NC providers · Browse ZIP 28310
Phone
9108078922
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in FORT BRAGG, NC

Name Credential NPI
MR. PHILIP JON ROYER DPT 1225037716
DANIEL MILLARD JAYNE PT 1427021179
HENRY MATTHEW DEITERS PT 1699742940
MRS. PATRICIA ANN CHIPPENDALE PT 1003876475
DR. MELISSA DAWN FOLSOM DPT 1396707055
MR. RICHARD T PETERS DPT OCS 1407811698
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.